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101.
Bedogni A Saia G Bettini G Tronchet A Totola A Bedogni G Ferronato G Nocini PF Blandamura S 《Oral oncology》2011,47(5):420-424
Surgical treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is controversial. Current recommendations contraindicate aggressive surgery because its results are unpredictable and may trigger disease progression. In this prospective study, we assessed the effectiveness of surgical resection of the jaws in cancer patients with BRONJ. Between June 2004 and July 2009, 30 cancer patients with refractory BRONJ underwent surgical resection of the jaws at our Units. They were followed-up weekly for the first month, at 3-month intervals up to 1 year, and at 6-month intervals up to 2 years. Panoramic radiographs and CT-scan were obtained at 3, 6, 12, 18 and 24 months. Primary outcomes were the 24-month recurrence rate of BRONJ and the 24-month mortality rate. Secondary outcomes were post-operative complications, duration of hospital stay after surgery, time to return to oral diet, and degree of oral pain. The 30 patients had a median age of 66 years and were mostly females (80%). Twenty-eight underwent a single resection and two had both jaws resected, for a total of 32 resected jaws. The cumulative recurrence rate of BRONJ in resected jaws 3.1% and 9.4% at 3 and 6 months, respectively. All the jaws with recurrent BRONJ had osteomyelitis at the margins of bone resection. The cumulative incidence of death was 3%, 12% and 16% at 12, 18 and 24 months. Surgical resection of BRONJ was highly effective, with few post-operative complications and were not associated with long-term mortality. 相似文献
102.
Francesca Maria Tanca Clelia Madeddu Antonio Macciò Roberto Serpe Filomena Panzone Giorgia Antoni Elena Massa Giorgio Astara Giovanni Mantovani 《Mediterranean journal of nutrition and metabolism》2009,2(1):29-36
Cancer-related anorexia/cachexia syndrome (CACS) is a multifactorial syndrome characterised by tissue wasting, particularly
lean body mass (LBM), metabolic alterations, fatigue, anorexia and reduced food intake. In April 2005 we started a phase III
randomised study to establish the most effective and safest treatment for CACS addressing as primary endpoints: LBM, resting
energy expenditure (REE), total daily physical activity, interleukin (IL)-6 and tumour necrosis factor (TNF)-α levels, and
fatigue. According to the statistical design the sample size was 475 patients (95 per arm). Eligibility criteria: histologically
confirmed tumours of any site; weight loss −5% in the last 3 months and/or abnormal laboratory values; life expectancy >4
months. Patients were treated with either antineoplastic therapy or supportive care. All patients received as basic oral treatment
polyphenols plus alpha lipoic acid plus carbocysteine plus vitamins A, C and E. Patients were then randomised to one of the
following 5 arms: (1) medroxyprogesterone acetate (MPA)/megestrol acetate (MA); (2) pharmaconutritional support containing
eicosapentaenoic acid (EPA); (3) l-carnitine; (4) thalidomide; and (5) a combination of all the above agents. Treatment duration was 4 months. Interim analyses
were planned after every 100 randomised patients. In September 2008, 280 patients were randomised and 240 were evaluable:
M/F 167/113, mean age 62 years (range 30-84), 96% stage IV. A first interim analysis on 125 patients showed a worsening of
LBM, REE and fatigue in arm 2 in comparison to the others and therefore it was withdrawn from the study. A second interim
analysis after the enrolment of 204 patients showed that arm 1 was clearly significantly less effective than the others for
primary efficacy endpoints, therefore it was withdrawn from the study. Statistical analysis in September 2008 showed a significant
improvement of LBM (by dual X-ray energy absorptiometry), REE and fatigue in arm 5, a decrease of IL-6 in arms 3 and 5, and
a decrease of TNF-α in arms 3 and 4. As for toxicity, 1 patient discontinued MPA because of deep vein thrombosis and 1 patient
discontinued L-carnitine because of severe diarrhoea. In conclusion, the interim results seem to suggest that the most effective
treatment for cancer patients with CACS/oxidative stress (OS) should be the combination regimen. The study is in progress. 相似文献
103.
Giorgia Pastorin 《Pharmaceutical research》2009,26(4):746-769
Amidst the myriad of Drug Delivery Systems able to enhance delivery, absorption and intracellular uptake of a bioactive molecule
while protecting it from deactivation, Carbon Nanotubes (CNTs) have emerged as a recent and promising option especially in
cancer therapy. This is mainly due to their unique properties, which render them extremely versatile through the incorporation
of several functional groups and targeting molecules at the same time, while their natural shape allows them to selectively
penetrate across biological barriers in a non-invasive way. In this expert review we aim to evaluate whether this innovative
material, once chemically-modified with suitable functionalizations, can be considered as a valuable system in comparison
to the already existing nanodevices. This will include the estimation of the most recent advances in the field of nanotechnology,
together with a cautious evaluation of potential risks and hazards associated with the extensive use of this fascinating,
but still unknown, nanomaterial. 相似文献
104.
105.
D'Amico A Petrini S Parisi F Tessa A Francalanci P Grutter G Santorelli FM Bertini E 《Neuromuscular disorders : NMD》2008,18(2):153-155
Limb-girdle muscle dystrophy type 2I is associated with mutations in the gene encoding Fukutin-related protein. Clinical phenotypes are heterogeneous, ranging from isolated hyperCkemia to severe congenital muscular dystrophy. Affected patients frequently develop dilated cardiomyopathy, depending on evolution of their skeletal myopathy. We report on an 8 years-old boy presenting a severe dilated cardiomyopathy requiring heart transplantation. The child harbored a homozygous p.Leu276Ile mutation in Fukutin-related protein gene (FKRP). At the current age of 20 years, the patient shows persistent hyperCKemia but no clinical muscle weakness, CT scan showing very mild features of muscle involvement. Our findings add to the array of clinical presentations of FKRP mutations. 相似文献
106.
Zulian F Woo P Athreya BH Laxer RM Medsger TA Lehman TJ Cerinic MM Martini G Ravelli A Russo R Cuttica R de Oliveira SK Denton CP Cozzi F Foeldvari I Ruperto N 《Arthritis and rheumatism》2007,57(2):203-212
OBJECTIVE: To develop criteria for the classification of systemic sclerosis (SSc) in children (juvenile SSc). METHODS: The study consisted of 3 phases: 1) collection of data on the signs and symptoms of actual patients with juvenile SSc that are useful for defining involvement of a particular organ; 2) selection of the parameters essential for the classification of juvenile SSc and preparation of a set of provisional classification criteria (PCC) using 2 Delphi surveys; 3) consensus conference consisting of 2 steps: discussion and rating of clinical profiles of 160 patients with definite juvenile SSc, possible juvenile SSc, or other fibrosing diseases as "having or not having juvenile SSc," using nominal group technique, and defining those PCC with the best statistical performance and highest face validity by using the clinical profiles of patients with definite juvenile SSc as the gold standard. RESULTS: In phase 1, 55 centers submitted clinical data on 153 patients with juvenile SSc. A total of 48 signs and symptoms were derived from these patient data and were used to define 9 organ system categories (cutaneous, vascular, gastrointestinal, respiratory, renal, cardiac, neurologic, musculoskeletal, and serologic). During phase 2, these were reduced to 21 criteria (3 major criteria [Raynaud's phenomenon, proximal skin sclerosis/induration of the skin, and sclerodactyly] and 18 minor criteria) and combined to generate 86 different PCC. At the consensus conference, these 86 definitions were tested on the case profiles of 127 patients with juvenile SSc. The PCC with the highest ranking were proximal sclerosis/induration and at least 2 minor criteria. CONCLUSION: These provisional classification criteria for juvenile SSc will help standardize the conduct of clinical research, epidemiologic and outcome studies, and therapeutic trials. 相似文献
107.
108.
Calzavara MB Andersen ML Fukushiro DF Lopez GB Abílio VC Tufik S Frussa-Filho R 《Progress in neuro-psychopharmacology & biological psychiatry》2008,32(5):1277-1282
We have recently demonstrated that paradoxical sleep deprivation (PSD) potentiates the induction of amphetamine (AMPH)-induced behavioural sensitization by increasing its conditioned component. In the present study, the effects of sleep rebound (induced by 24 h recovery period from PSD) were studied on AMPH-induced behavioural sensitization. Sleep rebound attenuated the acute locomotor-stimulating effect of AMPH. AMPH-induced behavioural sensitization was context-specific and was also attenuated by sleep rebound. These results strengthen the notion that sleep conditions can influence AMPH-induced behavioural sensitization. 相似文献
109.
Cozzi DA Ceccanti S Mele E Frediani S Totonelli G Cozzi F 《Journal of pediatric surgery》2008,43(10):1802-1806
Background/purpose
No studies have investigated the cosmetic outcome of current approaches to pyloromyotomy in infants with hypertrophic pyloric stenosis. The purpose of this study was to evaluate the final appearance of the scar in patients undergoing circumumbilical pyloromyotomy.Methods
During a 16-year period, 86 infants underwent circumumbilical pyloromyotomy at our institution. A detailed questionnaire was created to document the family members' perceptions of the esthetic appearance of the scar. Data were collected by telephone interview and at clinic visit. In addition, cosmesis was assessed by 5 staff members who scored blindly the esthetic outcome of the scars with comparative photographs, using a categorical scale.Results
Fifty-seven families were tracked by telephone contact. In the family questionnaire, 100% of families reported an excellent or good scar. Of these, forty-one (72%) were available for cosmetic assessment. Follow-up ranged between 5 months and 15 years (mean, 6 years). The panel members ranked the scar, on average, as excellent or good for 90% of the patients. No assessor stated that a scar was unacceptable. Intra- and interobserver agreement was 0.72 and 0.78, respectively.Conclusions
Overall satisfaction with the cosmetic outcome of circumumbilical pyloromyotomy is very high. 相似文献110.
Cozzi DA Mele E d'Ambrosio G Totonelli G Frediani S Spagnol L 《Journal of pediatric surgery》2008,43(8):1502-1506